PREVISOR AI
Only part of it reaches their doctor.
Pepper changes that.
PEPPER
MAY 2026 · CONFIDENTIAL · PREVISOR AI
01 · THE PROBLEM
People don’t realise that the texture of how they live is critical clinical information.
Physicians aren’t trained to ask the questions that would surface it.
Appointments aren’t built to hold it even if they did.
Medicine has never had the infrastructure to read those signals as part of the health picture.
The data has always been there. The pathway from life to clinic is broken. Pepper closes the gap.
02 · WHY IT MATTERS
Margaret
78
“I’m absolutely fine”
Her family notices forgotten birthdays and a near-fall on the stairs. Margaret insists it is just age. So when she sits in her physician’s office, she is charming and cheerful. Her physician sees a well elderly woman. Neither knows she is on the early edge of cognitive decline. The signals are there. They are not in the room.
Priya
32
Exhausted by her own data
Oura ring. Apple Watch. Period tracker. Supplement cabinet. Two years of debilitating IBS, dismissed by her physician as stress. She has not been back in over a year. She is overwhelmed with information and has no one to make sense of it. She is training for Hyrox. Her body is telling a completely different story.
James
47
Invisible by choice
Successful. Reliable. Private. Since the divorce he has been quietly disappearing — eating once a day without meaning to, sleeping badly, filling the silence when his children are away with nothing. His physician does not know he can’t sleep. No one knows he is on his way to a stroke. The signs are there, but no one sees them.
“
A physician sees each person they treat for a total of roughly one hour a year.* We all know that is not enough. We are ready for something like Pepper.
*Based on published primary care utilisation research. Range across studies: 60–90 minutes per year.
03 · WHY NOW
We are at a moment in technology where clinical intelligence can be so much more powerful than the fifteen minute appointment currently delivers. Six conditions are converging at once.
Ambient AI in the exam room
Two-thirds of US hospitals adopted ambient clinical AI by 2025. The between-visits problem is not solved.
CMS reimbursement built for us
CPT 99457, 99458, 99490 cover remote monitoring. The billing rail exists before the product does.
Investor appetite is real
Abridge: $5.3B valuation. Category hit $600M revenue in 2025, 2.4x YoY. Capital is moving here now.
Concierge and DPC accelerating
$21B → $47B by 2034 (DPC). Physician-prescribed, cash-pay. Exactly the beachhead Pepper enters first.
Physician shortage, rising demand
Every appointment must do more with less time. A pre-visit brief is a productivity tool for an overwhelmed system.
Demographic certainty
10,000 Americans turn 65 every day. 73M over-65 by 2030. Growing on a fixed schedule.
Sources: MarketsandMarkets RPM 2025 · AHA Health Technology Survey 2025 · Grand View Research DPC 2024 · US Census Bureau 2024 · Abridge Series E 2026 · CMS CPT Fee Schedule 2025
04 · WHAT GIVES PEPPER ITS POWER
What gives Pepper its power is the centuries of wellness philosophy — from functional medicine to Eastern traditions — that already contain sophisticated frameworks for understanding how a person lives, what their body is telling them, and how to read the signals that precede decline.
What we are doing that is new is creating the technology to use those frameworks as design intelligence: a platform that understands a person the way a skilled practitioner understands them at scale, continuously, in the ordinary moments of a person’s daily life.
Pepper does not teach people functional medicine or Eastern philosophy. It uses the wisdom embedded in those traditions to guide how it interacts with a person and what it reads as significant.
Design intelligence for capturing life
Conventional medicine
Pepper extends medicine — it does not replace it.
Social
Connection & withdrawal
Cognitive
Alertness & memory
Purpose
Motivation & meaning
Physiological
Sleep & movement
05 · THE PRODUCT
Physician-prescribed
Entering a person’s life with clinical authority. Sitting within existing CPT reimbursement pathways.
What the person experiences
A service that is present across the ordinary days of their life. Companionship is what the person feels. Clinical intelligence is what the physician receives.
What the physician receives
Before every appointment: a continuous and structured picture of a person’s life that no consultation has previously been able to provide.
Where the value lives
In the months and years before a diagnosis becomes necessary, when the trajectory is already forming and there is still time to change it.
The listening spectrum
1
Structured baseline
Constitutional baseline period. 30 days.
Pilot Phase 1
2
Responsive presence
Receives what a person brings, reflects back. Never initiates topic.
◆ MVP Layer 1
3
Relational inquiry
Questions emerge from what was said. Follows the person’s lead.
Current tech level
4
Guided inquiry
Pre-planned questions. Physician-triggered only.
Functional medicine model
Pepper does not follow a script, it follows the person.
06 · EVIDENCE
Glenn
Subclinical pattern detected
Lifelong runner. Presenting as healthy.
Pepper says
“Are you feeling burnt out, or is there something specific driving the change?”
Tara
“Facade” detection
Three cancelled physicals. Deflecting headaches as motherhood.
Accumulating avoidance pattern fires. All three facade indicators active simultaneously.
Pepper says
“We know it’s not just that, Tara… you’re experiencing symptoms that are impacting your daily life.”
Walter
Longitudinal memory working
Blood pressure monitoring. Memory and recall.
Doctor’s name, BP reading and medication held across an off-topic digression about a bird feeder. Recalled correctly ten turns later.
Pepper says
“Dr. Patterson said 130 over 85, she mentioned watching the sodium.”
Seven personas tested
Clinical signal extracted automatically
Zero false positives on facade detection
Full demo available on request
07 · THE DATA ASSET
Person
A continuous reflection of their own patterns builds awareness and motivation. The longer Pepper runs, the more useful it becomes.
Physician
Each appointment is informed by a fuller picture than any consultation has previously provided. Clinical judgement improves as the data deepens.
Pepper
Family
Confidence that the people they care about are being seen and understood, even between visits.
Researchers
A longitudinal dataset of relational and behavioural signal that has never existed at this scale — valuable for understanding the earliest markers of cognitive decline, depression and chronic disease.
US RPM market
$29.13B
by 2030, from $14.15B in 2024 — a 12.8% CAGR.
No current competitor integrates continuous relational signal monitoring into routine physician care.
*The data asset Pepper builds does not exist in clinical research or EHR systems. Research platforms capture behavioural signal in time-limited trials, not as a continuous layer of clinical intelligence integrated into routine physician care. · Source: MarketsandMarkets, 2025
08 · BUSINESS MODEL
Pepper sits inside existing CPT reimbursement codes. The physician earns from prescribing it.
Personal subscription. Three ways to pay.
Insurance reimbursement
Existing RPM CPT codes 99457 · 99458 · 99490. Insurance pays ~$130; the person co-pays ~$20. Opens the market well beyond cash-pay.
HSA-qualified — paid with pre-tax dollars.
Cash-pay — the person pays the practice directly.
Split three ways — $50 each
$50
Physician
Net income per person. No additional clinical time. Aligned incentive to prescribe. 20 people = $1,000/month per physician.
$50
Previsor
$50
Hardware & Ops
Mac Mini (~$700) amortised over 24 months. Care centre, three-day replacement, HIPAA-compliant infrastructure. Fixed cost. Spreads across the installed base.
>50% gross margin
~$0 customer acquisition cost
~$0 per-device cloud compute
CPT codes already exist
09 · COMPETITIVE LANDSCAPE
Daily relationship
Clinical NLP
In-home capture
Physician in loop
Preclinical insights
Cash-pay channel
ElliQ
$85M raised
Yes
No
Yes
No
No
Yes
General-purpose LLMs
ChatGPT · Claude · Gemini
No
No
No
No
No
No
Smart health devices
Hero Health et al.
No
No
Yes
No
Limited
Yes
RPM Devices
Vitals only
No
No
Limited
Limited
Limited
No
Wearables
Biometrics only
No
No
Limited
No
Limited
No
Pepper
Physician-prescribed
Yes
Yes
Yes
Yes
Yes
Yes
ElliQ reduces loneliness. It does not surface preclinical insights. A general-purpose chatbot answers questions when asked. It holds no daily relationship and has no physician in the loop. None of them sit where Pepper sits.
10 · THE PILOT
90-day pilot. 30-day structured baseline period. 60 days at Layer 1 Responsive Presence. Pre-Visit Brief before every appointment. Pilot partners in negotiation across primary care and functional medicine practices in Central New York. Full demo available on request.
CONVENTIONAL
Practice 1
Anchors institutional credibility. Tests Pepper inside the most time-pressured clinical environment. Builds the case for AMC partnerships and payer conversations.
CONVENTIONAL
Practice 2
Replicates signal across a second conventional practice. Validates consistency. Strengthens the evidence base for a multi-site Series A.
FUNCTIONAL MEDICINE
Practice 3
Tests cash-pay traction with people who already pay out of pocket for novel diagnostic intelligence. Highest-probability source of an early paid extension.
Four proof criteria
1
Clinical signal validity
2
Relational integrity
3
Physician utility
4
Financial viability
11 · TEAM
Clinical practice · Cross-cultural psychology · Relational AI design · Healthcare commercialisation · Infrastructure engineering
Dana Hoffer
Exec Chair & Chief Technical Officer
Built ventures from network infrastructure to AI-powered products. Engineering depth and entrepreneurial execution.
Ananya Rao-Middleton
President & Chief Relational Intelligence Officer
Founder, Institute of Relational AI and Churchill Fellow. Leads Pepper’s operational strategy.
David Wetherhold, MD
Chief Clinical Officer
Practicing internist and CMIO at Scripps Health. 30 years of practice with ambient-AI implementation.
Nandini Nayak, PhD
Strategic Advisor
Presidential Innovation Fellow. Clinical and cognitive psychology. Designed Pepper’s wellbeing framework.
Jane Hoffer
Head of Advisory
CEO/COO/founder across startups and public exits. Unlocked $90M+ and scaled revenue 10× through global partnerships.
12 · THE ASK
Do you believe in the problem?
The gap between what a person’s life reveals and what their physician can act on is a structural problem that has not yet been addressed at scale. The signals that precede a crisis are present, continuous and invisible to the current clinical system.
Do you believe in the product direction?
A physician-prescribed service that captures relational and behavioural signal continuously, translates it into a structured clinical brief and builds a longitudinal data asset that compounds in value over time. Clinical authority first. Consumer channel second.
Do you believe in the first steps?
A 90-day pilot with two conventional primary care practices and one functional medicine practice. A proof point framework built on four criteria: clinical signal validity, relational integrity, physician utility and financial viability. First clinical partner conversations underway by end of Q3 2026. This round funds the pilot and generates the clinical validation data needed to close Series A from a position of demonstrated signal validity.
Investment ask
Team
~40%
$700K – $900K · Founder runway through pilot. One clinical lead hire.
Engineering
~25%
$400K – $500K · Layer 1 conversational engine. Pre-Visit Brief generator. Edge orchestration.
Pilot & Evidence
~30%
$500K – $650K · Hardware. Physician compensation. Regulatory, clinical clearance.
Operations
~5%
$200K – $250K · Insurance, fractional CFO, legal retainer, 10% contingency.
Validated clinical signal
Foundational data asset
Series A from strength